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Clinical implications of anticoagulant oral therapy in elderly patients with hip fracture

BACKGROUND AND AIM: Proximal femur fractures (PFFs) are among the most common fractures, especially in the elderly population. A PFF often represents a life-changing event. Their dramatic effects are attributable not only to the massive hemorrhages caused by the fracture, but also and due to the hig...

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Autores principales: Cosseddu, Fabio, Ipponi, Edoardo, Perna, Luigi, Paterni, Simone, Andreani, Lorenzo, Capanna, Rodolfo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Mattioli 1885 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9335443/
https://www.ncbi.nlm.nih.gov/pubmed/35775766
http://dx.doi.org/10.23750/abm.v93i3.12606
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author Cosseddu, Fabio
Ipponi, Edoardo
Perna, Luigi
Paterni, Simone
Andreani, Lorenzo
Capanna, Rodolfo
author_facet Cosseddu, Fabio
Ipponi, Edoardo
Perna, Luigi
Paterni, Simone
Andreani, Lorenzo
Capanna, Rodolfo
author_sort Cosseddu, Fabio
collection PubMed
description BACKGROUND AND AIM: Proximal femur fractures (PFFs) are among the most common fractures, especially in the elderly population. A PFF often represents a life-changing event. Their dramatic effects are attributable not only to the massive hemorrhages caused by the fracture, but also and due to the high risk of dramatic complications. These risks are supposed to be even higher for patients under oral anticoagulant treatment. In this study we evaluated how oral anticoagulant therapy effected patient’s prognosis. METHODS: Ours was a case-control review of geriatric-aged patients treated surgically for proximal femur fractures between 2013 and 2019. Cases were divided in 2 groups depending if they were (Group A) or were not (Group B) under oral anticoagulant therapy at the moment of hospitalization. RESULTS: 200 cases were included in our study: 100 in Group A and 100 in Group B. Surgical delay was significantly higher for cases under oral anticoagulant treatment compared to the other cases. Group A cases were transfused with a significantly higher frequency and with more blood units compared to Group B (p=0.0300; p=0.013). Combined cardiological and vascular complications occurred in 21 cases (10.5%), being significantly more common in Group A (16) than Group B (5), as testified by a chi-square test (P=0.011). CONCLUSIONS: Cases under oral anticoagulant therapy are fragile patients with a higher risk to develop massive hemorrhages. For this reasons, it is mandatory to achieve an early stabilization of patient’s clinical conditions and then perform surgery as soon as possible. (www.actabiomedica.it)
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spelling pubmed-93354432022-08-15 Clinical implications of anticoagulant oral therapy in elderly patients with hip fracture Cosseddu, Fabio Ipponi, Edoardo Perna, Luigi Paterni, Simone Andreani, Lorenzo Capanna, Rodolfo Acta Biomed Original Article BACKGROUND AND AIM: Proximal femur fractures (PFFs) are among the most common fractures, especially in the elderly population. A PFF often represents a life-changing event. Their dramatic effects are attributable not only to the massive hemorrhages caused by the fracture, but also and due to the high risk of dramatic complications. These risks are supposed to be even higher for patients under oral anticoagulant treatment. In this study we evaluated how oral anticoagulant therapy effected patient’s prognosis. METHODS: Ours was a case-control review of geriatric-aged patients treated surgically for proximal femur fractures between 2013 and 2019. Cases were divided in 2 groups depending if they were (Group A) or were not (Group B) under oral anticoagulant therapy at the moment of hospitalization. RESULTS: 200 cases were included in our study: 100 in Group A and 100 in Group B. Surgical delay was significantly higher for cases under oral anticoagulant treatment compared to the other cases. Group A cases were transfused with a significantly higher frequency and with more blood units compared to Group B (p=0.0300; p=0.013). Combined cardiological and vascular complications occurred in 21 cases (10.5%), being significantly more common in Group A (16) than Group B (5), as testified by a chi-square test (P=0.011). CONCLUSIONS: Cases under oral anticoagulant therapy are fragile patients with a higher risk to develop massive hemorrhages. For this reasons, it is mandatory to achieve an early stabilization of patient’s clinical conditions and then perform surgery as soon as possible. (www.actabiomedica.it) Mattioli 1885 2022 2022-07-01 /pmc/articles/PMC9335443/ /pubmed/35775766 http://dx.doi.org/10.23750/abm.v93i3.12606 Text en Copyright: © 2022 ACTA BIO MEDICA SOCIETY OF MEDICINE AND NATURAL SCIENCES OF PARMA https://creativecommons.org/licenses/by-nc/4.0/This work is licensed under a Creative Commons Attribution 4.0 International License
spellingShingle Original Article
Cosseddu, Fabio
Ipponi, Edoardo
Perna, Luigi
Paterni, Simone
Andreani, Lorenzo
Capanna, Rodolfo
Clinical implications of anticoagulant oral therapy in elderly patients with hip fracture
title Clinical implications of anticoagulant oral therapy in elderly patients with hip fracture
title_full Clinical implications of anticoagulant oral therapy in elderly patients with hip fracture
title_fullStr Clinical implications of anticoagulant oral therapy in elderly patients with hip fracture
title_full_unstemmed Clinical implications of anticoagulant oral therapy in elderly patients with hip fracture
title_short Clinical implications of anticoagulant oral therapy in elderly patients with hip fracture
title_sort clinical implications of anticoagulant oral therapy in elderly patients with hip fracture
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9335443/
https://www.ncbi.nlm.nih.gov/pubmed/35775766
http://dx.doi.org/10.23750/abm.v93i3.12606
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